Indian Journal of Pathology: Research and Practice

Mixed gonadal dysgenesis represents a genetically, phenotypically and clinically heterogenous entity. It is defined by the presence of dysgenetic testis or streak gonads on one side and differentiated testis on the other side. The exact incidence of MGD is unknown. They can present in childhood with abnormal or ambiguous external genitalia or in an adult with history of primary amenorrhea in female and infertility in male. This discussion briefs about a case of mixed gonadal dysgenesis which is presented here for its rarity. A 22 year old female presented with history of primary amenorrhea. A complete clinical, hormonal, radiological and karyotypic analysis followed by exploratory laparatomy with histological examination of the gonadectomy specimens revealed a diagnosis of mixed gonadal dysgenesis. An important differential diagnosis for MGD includes true hermaphroditism. Histopathological examination of the gonads helps in confirming the diagnosis of MGD.

Keywords: Mixed Gonadal Dysgenesis; True Hermaphroditism; Persistent Mullerian Duct Syndrome.

Biotinidase is responsible for cleaving Biotin from Biocytin. Deficiency of biotinidase affects carboxylase enzymes causing dermatological, neurological, immunological or Ophthalmological complications. Biotinidase deficiency is known inborn error of metabolism having a prevalence of 1: 60,000 live births. We are presenting a case of biotinidase deficiency detected and diagnosed at our center.

Keywords: Biotinidase; Biotin; Biocytin; TLC; Organicaciduria. 

Introduction: Lymph node enlargement results due to proliferation of one or more components of the lymph node as a natural immune response to different antigens. Lymphadenopathy, whether localized or generalized, superficial or visceral, is a common finding in patients. Excision biopsy is the procedure of choice because histological diagnosis depends upon the change in the lymph node architectural pattern as well as the morphological details of the individual cells. Objective: The purpose of the present study was to evaluate the etiology of lymphadenopathy in relation to age and sex and the pattern of histological diagnosis in lymph node biopsy specimens in the department of histopathology in our centre. Materials and Methods: The present retrospective study of lymph node biopsies was conducted in the department of histopathology over a period of one year from January to December 2016. A total of 49 lymph node biopsies were taken into consideration. All biopsies were fixed in 10% formalin for 24 hours and later 3-4 micron thick sections were made from the blocks and staines with Hand E stain.Wherever necessary, AFB staining and immunohistochemistry was performed to aid in the diagnosis. Results: A total of 49 lymph node specimens were received from January 2016 to December 2016 . There were 17 (34.7%) males and 32 (65.3%) females. Cervical lymph nodes were the most commonly biopsied group (65.3%), non-neoplastic lesions were more common comprising 47out of 49 ( 95.9%). TB was the most common cause of lymphadenopathy and accounts for 59.18% of all lesions. Conclusion: Biopsy of the enlarged lymph nodes plays a major role in arriving at a correct etiological diagnosis of lymphadenopathy. Non neeoplastic causes like Tuberculosis with a female preponderance and cervical region was the commonest site affected in our study.

Keywords: Lymphadenopathy; Tuberculosis; Reactive Hyperplasia. 

Salivary glands are unique secretory glands due to its histological diversity and heterogeneity. More than 90% pleomorphic adenoma (PA) are found in majorsalivary gland i.e. parotid. This tumor is known to occur at various other anatomical locations apart from the major salivary glands. 8% of PAs involve the minor salivary glands of which 60-65% in the palate and 5.5% at minor salivary glands of cheek. Less frequent sites such as lacrimal gland, external auditory canal, breast and parapharyngeal space, reported sparsely in English literature. PA at breast and external auditory canal (EAC), can be challenging and may lead to a misdiagnosis, as invasive carcinoma. Involvement of parapharyngeal space are also rare and constitute less than 0.5% of head and neck neoplasm. We are presenting here a series of 10 cases of PA at unusual sites with an aim to highlight the role of FNAC, which has sufficiently high accuracy rate and can be a useful guide in making decisions for further management.

Keywords: Pleomorphic Adenoma; Unusual Sites; Aspiration Cytology; Diagnostic Accuracy.

Background: Malignancies of Salivary gland are not uncommon. Among all the neck and head tumors, they account for 2-6.5% of all tumors. For evaluation of tumors of salivary gland, fine needle aspiration cytology (FNAC) is a commonly used method. Objective: To study the efficacy of FNAC in the diagnosis of salivary gland lesions. Methods: Present study was hospital based diagnostic evaluation study conducted among 96 FNACs from December 2013 to May 2015. The study was conducted in the department of Pathology at a tertiary care hospital. Gold standard used was histopathology of lesions. Results: The FNAC findings in this study were: Non-neoplastic 40, Benign 46, Malignant 7, and Suspicious for malignancy 2 and unsatisfactory. Biopsy examination for comparison was available in 37 cases. Sensitivity of FNAC was 100% and the specificity was found to be 96.97%. The positive predictive value was 80% and the negative predictive value was 100%. The overall diagnostic accuracy in the present study was 97.3% for FNAC. Conclusion: FNAC is less costly, rapid, safe technique. The best part is that this technique is minimally invasive technique. It is as good as a diagnostic test.

Keywords: Histopathology; Salivary Gland; Lesions; Technique; Diagnostic Test; FNAC. 

Context: The initial classification of anemia can be improved substantially by including RDW and histograms of the red cell volume as these variable become part of the routine blood counts. Aims: To evaluate the effectiveness of the RDW parameter in the diagnosis of the erythrocyte disorders. Settings and Design: A hospital based cross sectional diagnostic evaluation study, Department of Pathology, Lt. BRKM Government Medical College. Methods and Material: 250 randomly selected cases of anemia were studied. All patients having hemoglobin value of less than 12.5 gm were included in the present study. Initially all patients were screened by automated cell counter. Those with hemoglobin of less than 12.5 gm were included in the present study. A possible pathophysiologic entity was assigned. Now the peripheral smear was screened and a specific etiology (category or cases) was assigned. Statistical Analysis: Chi square test was used wherever appropriate. P value of less than 0.05 was taken as statistically significant. Results: Decreased MCV and mild increase in RDW was seen in thalassemia trait. Serum iron was found to be normal in IDA patients. Low MCV and high RDW was found to be a good predictor of IDA. Single parameter of high MCV was found to be of poor diagnostic value in B12 deficiency anemia. Very high RDW was a consistent feature of sickle cell disease. Fairly deciding heterogeneity was observed with decrease to normal MCV in cases of various types of hemolytic anemia. Conclusion: RDW is a fairly sensitive and specific diagnostic approach and can eliminate unnecessary expensive and invasive investigations.

Keywords: Sickle Cell Disease; Iron Deficiency Anemia; Beta Thalassemia; MCV; RDW; MCH. 

Background: Seventh most common tumor is urinary bladder tumor among which urothelial carcinoma constitutes 90% of primary bladder tumor. Both neoplastic and non neoplastic diseases produce clinical signs and symptoms. Though the non-neoplastic diseases are disabling, the neoplastic lesions are the source of mortality. This study was conducted to analyze frequency and clinical features of various histopathological lesions of bladder tumors. Materials and Methods: this retrospective study was carried out in the department of pathology, Narayana medical college, Nellore. Clinicopathological data of bladder biopsies received from urology department were analyzed. Results: 68 bladder biopsies were studied. Among them 53 cases were neoplastic and 15 cases were non neoplastic lesions. Both neoplastic and non-neoplastic lesions showed male predominance. Neoplastic lesions were noted in the age group of 61-70 years (28.3%) . Non-neoplastic lesions showed predominance in the 31- 40 years age group. Among the neoplastic lesion low grade papillary urothelial carcinoma invading lamina propria constituted maximum number (32.1%) followed by high grade urothelial carcinoma invading muscle layer (24.4%). Few rare tumors like urachal adenoacrcinoma, mucinous adenocarcinoma, sarcomatoid urothelial carcinoma were also encountered in our study. Among the nonneoplastic lesions, granulomatous cystitis were maximum (46.6%) followed by non-specific chronic cystitis, cystitis cystica, cystitis glandularis and eosinophilic cystitis. Conclusion: In the bladder neoplastic lesions are more common than non-neoplastic lesions. Among the neoplastic lesions, papillary urothelial neoplasms are commonest. Grading of urothelial carcinoma along with presence or absence of muscle invasion is an important prognostic factor. Clinical signs and symptoms like haematuria should not be neglected as it may lead to advanced stage of neoplastic lesions at the time of diagnosis.

Keywords: Bladder Lesions; Urothelial Tumors; Non Neoplastic Lesions. 

Background: The salivary gland tumors account for 6% of all the head and neck tumors. Salivary gland lesions consist of non-neoplastic lesions and neoplastic lesions. FNAC is most commonly used method to diagnose the salivary gland tumors. The main objective of our study was to analyze the spectrum of salivary gland lesions and to evaluate the efficacy of cytology in diagnosing salivary gland lesions by correlating with histopathological findings. Methods: The present retrospective study of 50 cases of FNAC and histopathology of salivary gland lesions was carried out in the department of pathology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh, India, during the period of January 2016 to December 2016. Cytological smears were fixed in ethyl alcohol and then stained with Haemotoxylin & Eosin stains. Salivary gland specimens were fixed in 10% formalin and then stained the paraffin sections by Haemotoxylin & Eosin staining technique. Cytohistopathology correlation was done. Result: In our study, age range of salivary gland lesions was from 26 years to 68 years with a mean age of 43.32 years and female to male ratio is 1.5:1. Majority of the salivary gland lesions were noted in 31-40 years age group. Among the 50 cases of salivary gland lesions, 38(76%) cases were benign neoplasms, 7(14%) cases were malignant neoplasms and 5(10%) cases were inflammatory lesion. Among the benign neoplasms, Pleomorphic adenomas were 35 (92.11%) cases and among the malignant neoplasms, mucoepidermoid carcinomas were 4 (57.14%) cases. The overall diagnostic accuracy in salivary gland lesions was 94.67%. Conclusion: The high accuracy, sensitivity and specificity of FNAC confirm that preoperative cytology is a useful, quick, reliable diagnostic technique for rapid and early diagnosis in salivary gland lesions. Few rare tumors can be missed on cytology, but clinical correlation can give clue to the diagnosis of malignant neoplasms.

Keywords: Salivary Gland Lesions; Cytohistopathological Correlation. 

Introduction: Prostatism is a common disease in the geriatric age group. Benign prostatic hyperplasia and Carcinoma of the prostate are increasingly frequent with advancing age. Aim of the present cross-sectional study is to evaluate the complete spectrum of histopathological types of various prostatic lesions. Materials and Methods: A total of 75 prostate biopsies were received from January 2016 to December 2016 in the Department of Pathology, in a tertiary care hospital, Uttar Pradesh. Routine Hematoxylin and Eosin staining was performed. Reporting of malignant cases included Gleason’s grade and score. Relevant clinical data including the age, presenting complaints, and radiological findings were documented for all the cases. Results: A total of 75 prostate biopsies were received, the mean age was 63.04 years. Most common presenting complaint was difficulty in micturition. Study included, 56 (74.66%) cases of Benign prostatic hyperplasia alone and 5 (6.66%) were of Adenocarcinoma. Chronic Prostatitis 6 (8%) was the most common non-neoplastic lesion associated in cases of benign prostatic hyperplasia. Two (2.66%) cases were of benign prostatic hyperplasia along with Basal cell hyperplasia. One (1.33%) case each of granulomatous prostatitis, cystitis glandularis (urothelium), and squamous metaplasia were associated with benign prostatic hyperplasia. One (1.33%) case each of Prostatic intraepithelial neoplasia, Undifferentiated carcinoma, and post operative spindle cell nodule were also noted. Conclusion: Benign prostatic hyperplasia is the most commonly encountered prostatic lesion. In spite of availability of various investigations, a definitive diagnosis of prostatic lesions can be made by histopathological study only.

Keywords: Benign Prostatic Hyperplasia; Chronic Prostatitis; Basal Cell Hyperplasia; Prostatic Intraepithelial Neoplasia; Carcinoma Prostate; Post Operative Spindle Cell Nodule. 

Background: Squash smear technique is reliable diagnostic tool which provides neurosurgeons with rapid intraoperative diagnosis and helps them to modify their surgical approach. This study was done to assess the accuracy and diagnostic utility of squash smear technique by comparing with histopathological diagnsosis. Materials and Methods: Our study included 33 patients who underwent operation in neurosurgical department, Narayana Medical College and hospital, Nellore. Squash smear technique was used to provide intraoperative diagnosis and was correlated with histopathological diagnosis. Results: 33 cases were studied, out of which 2 were inflammatory lesions and 31 were neoplastic. Neoplastic lesions included astrocytomas (42.4%), meningiomas (27.3%), oligodendrogliomas (3.03%), ependymoma (3.03%), chordoma (3.03%), schwannoma (9.09%), choroid plexus papilloma (3.03%), and pituitary adenoma (3.03%). Non neoplastic cases were 2 cases of tuberculoma (6.06%). Accuracy rate of squash smear technique was 87.9% in our study. 100% accuracy was found in astrocytomas which were maximum in our study followed by meningiomas. Conclusion: squash cytology provides reliable and rapid diagnosis for neurosurgeons. Accuracy is good in astrocytomas when compared to inflammatory conditions and rare tumors like ependymoma and chordoma. Clinical features and radiological findings should be considered to increase the accuracy of squash cytology.

Keywords: Squash Cytology; Intraoperative Diagnosis. 

Introduction: Eosinophilic gastroenteritis is a rare inflammatory condition characterized by increase in number of eosinophils. There are various causes enumerated to eosinophilic gastroenteritis includes H pylori infection, drugs, parasites, allergen. Objective: To find the correlation between eosinophilic gastroenteritis and peripheral blood eosinophilia. Materials and Methods: 85 cases are selected.The diagnostic criteria for eosinophilic gastroenteritis is presence of more than 30 eosinophils per high power field. The absolute eosinophil count of all the cases is noted. Results: Among 85 cases, 59 are males and 26 are females. The mean age of male and female patients included in this study is 51.31 years and 52.46 years respectively. The most common site involved is colon. Kappa (weighted) statistics shows 36% agreement. Discussion: Our study shows only 36% patients have raised absolute eosinophil count. Conclusion: Eosinophilic gastroenteritis is common in 5th decade, more common in male patients. Since only 36% of patients have raised absolute eosinophil count. Biopsy remains the gold standard modality of diagnosis.

Keywords: Allergy; Colon; Eosinophilia; Gastroenteritis.

Background: Acute appendicitis is the one of the most common surgical emergencies in world wide. Gold standards method for diagnosis of acute appendicitis is histopathological examination of appendectomy specimen. Appendiceal lumen obstruction caused by faecolith mainly and unusual factors rarely. Spectrums of appendiceal lesions consist of inflammatory lesions to malignant lesions. Methods: The present retrospective study included 159 appendicectomy specimens received in the department of pathology, Narayana Medical College & Hospital. Nellore, Andhra Pradesh, India, during the period of January 2016 to December 2016. Appendicectomy specimens were fixed in 10% formalin and then stained with Haemotoxylin and Eosin staining technique. Results: Among the 159 appendicectomy specimens, Acute appendicitis account for 72 (45.28%) with peak occurrence in the age group 11-20 years (27.67%) and 21-30 years (25.79%) with male predominance (1.74:1). Unusual findings were noted in 21(13.21%) cases on histopathology. Most common unusual findings included chronic obliterative appendicitis (61.90%), followed by acute eosinophilic appendicitis (14.29%) and Carcinoid appendix (9.52%). Other unusual findings include Granulomatous appendicitis, Enterobius vermicularis parasitic infestation and primary adenocarcinoma of appendix. Conclusion: The gross examination of appendix during surgery cannot detect the unusual findings particularly malignancies. Histopathological examination of appendix is essential to avoid the malignancies missed and gives clinician a clear idea regarding treatment strategy.

Keywords: Appendicitis; Carcinoid; Primary Adenocarcinoma; Enterobius Vermicularis. 

Vitamin B12 is a neurotropic, water soluble vitamin and is one of the major cause of development of Diabetic peripheral neuropathy. Metformin is known to cause depletion of vitamin B12 stores resulting in its deficiency. Thus Looking at the increased incidence of type 2 Diabetes mellitus, and the increased prevalence of vitamin B12 deficiency in the Indian population (vegetarian diet being one of the factor) and since the screening of serum vitamin B12 is a bit costly test, according to the result of this study we may arrive to a conclusion regarding supplementation of vitamin B12 for prevention of peripheral neuropathy in diabetes. Long term use of Vitamin B12 supplements in patients will not cause any harm owing to the fact that it being a water soluble vitamin will be excreted in urine if in excess. Biothesiometer is a simple, portable, reliable, non-invasive method to screen the peripheral neuropathy.

Keywords: Vitamin B12; Diabetes mellitus; Metformin Therapy; Biothesiometer.

Background: Bethesda system of thyroid lesion is the six-tired diagnostic classification based on a probabilistic approach in increasing the specificity and sensitivity of FNAC thyroid lesions. Its capacity to facilitate better cytologic -histologic correlation and role of each diagnostic category to conveys specific risks of malignancy. Methods: The present retrospective study of Bethesda system of cytopathology of thyroid lesion was carried in 100 cases in the department of Pathology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh, India, during the period of January 2016 to December 2016. Cytological smears was fixed in ethylalcohol and then stained with Haematoxylin and Eosin staining technique. Results: In our study the lesion wise distribution after The Bethesda System of Reporting Thyroid Cytopathology (TBSRTC) was benign 77.5%, Atypia of undetermined significance 3.5%, with Follicular Neoplasm at 6%, suspicious for malignancy at 2% and malignant at 11%. The sensitivity and specificity after TBSRTC were 88.13% and 100% respectively with a diagnostic accuracy of 98.55%. On estimation of risk for malignancy in each category it showed 1.95% for benign lesions, 33.33% for Follicular Neoplasm category, suspicious for malignancy had 50% risk and 100% risk for malignancy category. Conclusion: The malignancy potential of each category of Bethesda system gives clinician a clear idea regarding its treatment strategy and TBSRTC has a histopathological correlation as good as any system of reporting.

Keywords: Thyroid Cytopathology; Bethesda System.

Background: Endometriosis is an important benign gynecologic pathology defined by presence of a tissue similar to uterine endometrium, which is located endometrial glands and stroma out side of the uterus associated with pelvic pain. The most common site is ovaries followed by posterior broad ligament, fallopian tubes, and colon and round ligaments. Objective: To evaluate the endometriosis cases through pathologic analysis of histological features, age, site, and clinical presentation of endometriosis. Materials & Methods: Retrospective study was undertaken for a period of 2years from May 2015 to May 2017 in department of pathology, Narayana Medical College & Hospital, Nellore, and Andhra Pradesh, India. Results: 20 Cases of endometriosis recorded in the department of pathology in 2 years (May 2015-May 2017). Of all endometriosis cases, majority were found in 30-40 years age group. Most common site was ovary 11 cases (55%), and least common site was abdominal wall (scar) 1 case (5%), sigmoid colon 1 case (5%). Most common presentation was pelvic pain 7 cases (35%) and dysmenorrhea 5 cases (25%), menorrhagia 4 cases (20%) , constipation 1 case (5%) and abdominal lump 1 case (5%). Common associated pelvic pathology was leiomyoma of uterus. Conclusion: Endometriosis has no pathognonomic signs or symptoms and it is difficult to diagnose clinically. Histopathology is gold standard test for confirmation of the diagnosis.

Keywords: Endometriosis; Histogenesis; Histopathology; Ovaries. 

Introduction: Cancer of the uterine cervix is one of the leading causes of cancer death among women worldwide. In India, it ranks as second leading cause next to breast cancer in women. Aims: To study the clinical presentation of cervical carcinoma correlating with histopathological findings in the Charutar area of Gujarat state at Shree Krishna Hospital, Karamsad. Methods and Material: 68 specimens received from 15 April 2015 to 14 April 2016 with clinical suspicion of cervical carcinoma and histopathologically confirmed were considered for study. Clinical details of the patients were noted with the help of semi-structured proforma. Statistical analysis used: The data was Statistically analyzed using STATA 14 software. Results: Out of 68 confirmed cases for malignancy, 43 (63.24%) had large cell non keratinizing squamous cell carcinoma (LCSCC), 34 (50%) were presented with abnormal bleeding per vaginum, 47 (69.12%) were seen between 41-60 years, 66 (97.06%) were multiparous, 48 (70.59%) had poor genital hygiene, 42 (61.76%) were illiterate, 44 (64.70%) were from low economic class, only 03 (4.41%) had history of cervical cancer screening. Conclusion: The most common cervical cancer in this region of India is squamous cell carcinoma. Majority patients had complained of bleeding per vaginum, between 41- 60 year, multiparous, had poor genital hygiene & illiterate. The study concludes that screening of cervical cancer should be emphasised in women especially in rural areas for early detection of cancer and reduce mortality and morbidity in productive age.

Keywords: Cancer; Awareness; Mortality; Hygiene; Screening. 

Background: It is a physiological process in women and is associated with risk to health of both mother and child. To prevent maternal and fetal morbidity and mortality by early assessment of severity of pre eclampsia and eclampsia. Objective: to compare the coagulation parameters between the test group and control group. Materials and Methods: A total number of 30 normal antenatal women without Pregnancy induced hypertension are included in control group and a total number of cases of Pregnancy induced hypertension are taken as test group. Comparision of coagulation parameters like Activated partial thromboplastin time, Prothrombin time and platelet count were studied in these patients. This study was undertaken for a period of one year of January 2016 to January 2017 in department of pathology, central laboratory, narayana medical college & hospital, Nellore. Results: Coagulation parameters such as Activated partial thromboplastin time, Prothrombin time and platelet count were studied in both 30 control and cases. Study showed significant alteration of coagulation profile depending on severity of disease. All results were statistically analysed. Conclusion: Estimation of different parameters like Activated partial thromboplastin time, Prothrombin time and platelet count play s a role in the diagnosis of Pregnancy induced hypertension and evaluation of risk factors, early detection of which will decrease maternal morbidity and mortality.

Keyords: Pregnancy Induced Hypertension; Preeclampsia; Activated Partial Thromboplastin Time; Prothrombin Time; Platelet Count. 

Background: The ABO and Rhesus (Rh) blood group systems are the most important human blood group systems and are responsible for most of the blood transfusion reactions, transplant rejections, parental testing and legal purposes. Settings and Design: A retrospective study was conducted at Blood Bank, GMC, Latur, and Maharashtra. A total of 6224 blood donors were studied, during the period from 1st January 2016 to 31st May 2017. Materials and Methods: ABO and Rhesus grouping of the donors were determined using the standard monoclonal antisera by slide agglutination method and reverse grouping. Statistical Analysis: The frequency of ABO and Rh blood group typing was expressed in simple percentages. Results: Out of 6224 donors, 6117(98.28%) were male and 107(1.72%) were female donors. The commonest ABO blood group was B (32.97%) followed by O (30.14%), A (26.38%) and least common AB (10.51%). Among 6224 donors, 298 (4.79%) were Rh negative while 5926 (95.21%) were Rh positive. Conclusion: Our study throws light on the distribution of blood groups in Latur region, which is important for blood banks and transfusion service policies that could contribute to National Health System.

Keywords: ABO; Rhesus; Blood Group; Donors.

Introduction: The most commonly encountered clinical problem are the lesions of the thyroid. Most of these can be treated medically or surgically. Fine needle aspiration cytology and histopathological examination together are very helpful in establishing the diagnosis. The role of a pathologist is thus very crucial in establishing the nature of thyroid lesions. Materials and methods: We have taken up a prospective study for a period of two years at Narayana Medical College and General Hospital. We have analysed a total of 250 cases during this period. Cytological and histopathological slides were reviewed and the results were analysed. Results: In our study there was a female predominance with non-neoplastic lesions predominating the neoplastic lesions. Nodular goiter was most common among benign lesions and papillary carcinoma was common in the malignant category. Histopathology plays an important role in the diagnosis of lesions which are missed on cytology or inconclusive on cytology. Conclusion: Fine needle aspiration cytology and histopathology go hand in hand in the diagnosis of thyroid lesions giving almost 100% results.

Keywords: Cytology; Histopathology; Thyroid; Lesions. 

Background: The nasal cavity and the paranasal sinuses form a single functional unit. Malignant sinonasal tumours are characterized by low incidence, non specific symptoms, and late presentation. The malignant sinonasal tumours encompass an entire range of both epithelial and non-epithelial tumours. Aims & Objectives: Our study aims to determine incidence, age, sex, site, mode of presentation and histological types of various malignant sinonasal tumours over a 5 year period. Methods: 107 malignant sinonasal tumors biopsied or surgically excised over a period of five years were studied. Results: We encountered 107 cases of malignant tumors with an incidence of 0.24%. Malignant tumors occurred with a mean age of 52.05 years and the male to female ratio was 2.3:1.Among malignant tumors, epithelial tumors (97 cases) constituting 90.65% predominated over non epithelial tumors (10 cases) constituting 9.35% with a ratio of 9.7:1. Out of the 107 cases 58 tumors involved the nasal cavity (54.21%) and 49 involved paranasal sinuses (45.79%). The most common malignant tumor encountered was squamous cell carcinoma-60 cases (56.07%). Conclusion: The clinical and radiological features of masses of nasal cavity and paranasal sinuses are overlapping and often only a provisional diagnosis is possible. Definite diagnosis requires histopathological examination.

Keywords: Sinonasal Tract; Malignancy; Squamous Cell Carcinoma; Epithelial; Nonepithelial. 

Background: Tuberculosis in India continues to be a major health problem with approximately one eight of total cases being extra pulmonary. The gastrointestinal tract is involved in 66-75% of cases of abdominal tuberculosis. The pathologist plays a central role in diagnosis of intestinal tuberculosis (ITB). Many intestinal lesions especially non-neoplastic share the same clinical background, where characteristic pathological features not only suggest specific diagnosis but also the extent and severity of the disease. Aim: To study the profile of tuberculous lesions of small and large intestine including appendix in relation to age and sex distribution, the clinical presentation and regional distribution of the lesions. Method: A prospective study of 30 diagnosed cases of ITB encounterd in surgically excised specimens of small and large bowel including appendix carried over a period of five years.The diagnosis was based on the presence of caseating or non-caseating epithelioid cell granulomas, acid-fast bacilli (AFB) on histology. Results: Intestinal obstruction was the most frequent clinical presentation in ITB cases in this series.The mean age was 34.2 years with M: F ratio of 2:1. Ileum and ileocaecal region weremost frequently involved. The three gross morphological forms of tuberculous enteritis seen were ulcerative in 70%, ulcero-hypertrophic in 20% and hypertrophic in 10 %cases. Characteristic caseating granulomas were seen in 60% cases. Conclusion: Along with clinical, radiological and endoscopic evaluation, the present study showed that histopathological analysis also plays an important role in the diagnostic and therapeutic approach to intestinal tuberculosis.

Keywords: Intestinal Tuberculosis (ITB); Acid- Fast Bacilli (AFB). 

Introduction: Cancer is one of the major health issues worldwide including India. Breast cancer is by far the most frequent cancer in females with rising incidence and usually presents at advanced stage at diagnosis making the outcome poor, however aggressive the treatment may be and leading to disproportionately higher mortality rates. Aims and Objectives: To study the age, incidence, clinical presentation and histomorphological pattern of carcinoma breast in all mastectomy specimens. Methodology: Four year retrospective study of 170 mastectomy specimens received in the department of pathology from Jan 2012 to Dec 2016. All the sections were retrieved and diagnosis were confirmed and the necessary clinical data was obtained from records department. Histological grading were done according to Modified Scraff-Bloom-Richardson Method. Results: The commonest presenting symptom was painless lump (65% of patients) with slight left breast predominant involvement (55%). The most common site of location were in upper outer quadrant (35%) and the least in subareolar region (3%). Among the histological varieties invasive duct carcinoma not otherwise specified was the commonest (83%) and the least was tubular carcinoma (0.5%). Majority of the patients were between 41-50 years (45%). 56% of cases showed evidence of metastasis in lymph nodes. In our study, 52.1% of carcinomas were in Grade I, 41.3% were in Grade II, and 6.6% were Grade III. Conclusion: Carcinoma breast is affecting young to middle age group and the number of cases increasing every year and we cannot prevent this cancer, all we can do is Breast Awareness and screening programmes is the need of the hour.

Keywords: Breast; Mastectomy; Infiltrating Duct Carcinoma; Tumor Size; Grade. 

Context: Cytopathological assessment of bronchoscopy specimens plays a crucial role in the diagnosis of bronchopulmonary lesions. Aim: Our study was aimed to assess the diagnostic efficacy of cytological techniques in bronchopulmonary lesions in correlation with histopathological examination findings. Settings and Design: Correlative study. Methods and Material: 250 patients with symptoms and signs of pulmonary lesions were selected for the study and bronchoscopy was performed. Specimens from bronchial brush followed by bronchioalveolar lavage were collected and routinely stained with Papanicolaou, Hematoxylin & eosin and Giemsa stains and studied. Special stains like Per-iodic acid Schiff and Ziehl-Neelson were performed as per requirement. Endobronchial biopsy specimens were processed as per routine histopathological techniques and stained. Statistical analysis used: Sensitivity, Specificity, Positive Predictive value, Negative Predictive value and Diagnostic Accuracy. Results: The age of the patients ranged from 20 to 87 years. The male to female ratio was 3.2:1. Out of 250 cases, neoplastic lesions were seen in 48 cases and non-neoplastic lesions were observed in 202 cases. Bronchoalveolar lavage cytology showed 36 true positive cases and 202 true negative cases, Bronchial brushing cytology showed 46 true positive cases and 202 true negative cases as confirmed by Bronchial biopsy. Conclusion: Diagnostic efficacy levels of cytological techniques in pulmonary lesions have acquired sensitivity levels high enough to be recommended for use as routine and definitive diagnostic tools in the evaluation of bronchopulmonary lesions.

Keywords: Bronchoscopy; Endobronchial Biopsy; Cytopathological Assessment; Sensitivity; Specificity. 

Identifying and employing appropriate learning styles could play an important role in selecting teaching styles, which can improve education ultimately.The present study aimed to assess the diversity of learning styles amongst medical students of a Basaveshwara Medical College, Chitradurga, Karnataka in 2014. A cross-sectional study which employed VARK learning style’s questionnaire was done on 89 Second year medical sciences students. Data was collected with use of VARK questionnaire. The validity of the questionnaire was assessed on basis of experts’ views and its reliability was calculated by using Cronbach’s alpha coefficients. Data were analysed by using SPSS software and Chi-square test. The preferred learning styles of medical students in the present study were aural and reading/writing. It is suggested that all medical students must be tested to determine their desired learning styles by using VARK questionnaire, also to choose appropriate teaching methods and to improve educational goals.

Keywords: Visual; Aural; Kinesthetic; Reading; Writing; Quad Modal. 

Background: Platelets are the important constituents of blood which are the main players during the process of thrombus formation. Endothelium produces a large number of substances that affect blood flow and can lead to a hypertensive state. Large observational studies indicate that in hypertension, cardiovascular morbidity and mortality are related to the severity of hypertensive state and to the development of cardiac and vascular changes. Platelet count (PLC) and elevated mean platelet volume (MPV) levels are thought to be closely associated with cardiovascular diseases such as acute ischemic stroke, left ventricular hypertrophy, carotid atherosclerosis as well as hypertension. This study was done to evaluate PLC and MPV in hypertensive patients compared to control normotensive subjects. Methods: This was a cross sectional case control study in tertiary care hospital in Mangalore. During this study period 50 control and 50 cases were analyzed. Results: Among the controls majority are males (68%) with mean age of 44 years. Among the cases, majority are males (62%), with mean age of 60 years. In control, mean PLC were 2, 53,380 cells and average MPV was 8.46 fL. Among the case group, the mean PLC was 2, 36, 417 cells and average MPV was 8.40 fL. Since the p values are more than 0.05, there is no difference in PLC and MPV in cases and controls at the 5% level of significance. There was no increase in the platelet indices in hypertensive patients compared to normotensive patients. Conclusion: Though we started our study anticipating an increase in PLC and MPV in hypertensive patients, the results we obtained could not prove such a correlation. A further study and research involving a great number of patients is needed in this field to support the hypothesis.

Keywords: Platelet Count; Mean Platelet Volume; Hypertension; Correlation.